Hypergonadism

Last updated

Hypergonadism is a condition where there is a hyperfunction of the gonads. [1] It can manifest as precocious puberty, and is caused by abnormally high levels of testosterone or estrogen, crucial hormones for sexual development. In some cases, it may be caused by a tumor, which can be malignant, but is more commonly benign. [2] Anabolic steroids may also be a major cause of high androgen and estrogen functional activity. Other possible causes include head injuries and brain inflammatory diseases. [3] Hypergonadism may contribute to symptoms such as precocious puberty and abnormal facial hair growth in females. [4]

Contents

Symptoms

Men and women exhibit different symptoms for hypergonadism. A few of the symptoms that men can experience are increased sex drive, early balding, excessive muscle mass, and acne. Women can have symptoms such as, increased growth of facial hair, deepened voice, coarse body hair, and an irregular menstrual cycle. [5]

Historical Understanding

In ancient civilizations, hypogonadism was often misunderstood and poorly differentiated from other health issues. Conditions related to sexual development and function were commonly attributed to imbalances of the humors in ancient Greek and Roman medicine. [6] During the Renaissance, there was some early recognition of endocrine system function, but it wasn’t until the late 19th and early 20th centuries that hypogonadism was properly identified and linked to hormone production issues. This shift in understanding followed the development of endocrinology as a distinct medical field. [6]

Cultural & Social Impacts

Throughout history, individuals with symptoms of hypogonadism, particularly men who exhibited low libido, infertility, or underdeveloped secondary sexual characteristics, often faced social stigma. [7] In many cultures, fertility and sexual vitality were closely tied to masculinity and virility, leading to shame and social exclusion for those affected by the condition. In modern times, however, greater awareness of hypogonadism as a medical condition has reduced some of the social stigma, particularly as hormone replacement therapies have become more widely available. [7]

Environmental & Dietary Factors

Environmental and dietary factors have also been linked to the prevalence of hypogonadism, particularly in regions where malnutrition or environmental toxins are common. For example, exposure to endocrine-disrupting chemicals (EDCs) such as phthalates and bisphenol A (BPA) has been associated with reduced testosterone levels in men. [8] In historical contexts, poor nutrition during periods of famine or in areas with inadequate food diversity may have contributed to higher rates of hypogonadism, particularly in younger males. [8]

Medical & Technological Advancements

Significant medical advances have revolutionized the treatment of hypogonadism. The discovery of testosterone in 1935 led to the development of testosterone replacement therapy (TRT), which has since become a cornerstone treatment for male hypogonadism. Additionally, hormone replacement therapy (HRT) for women has advanced, providing solutions for conditions such as menopause-related hypogonadism. [9] Advances in reproductive technology have also enabled individuals with hypogonadism to conceive using assisted reproductive techniques, further improving quality of life. [9]

While hypogonadism has historically been a misunderstood condition with social consequences, modern medical advancements have led to effective treatments and a better understanding of the underlying causes. Research continues into the environmental and dietary factors contributing to this condition, ensuring that future medical interventions will be even more effective at preventing and managing hypogonadism in both men and women.

See also

Related Research Articles

Delayed puberty is when a person lacks or has incomplete development of specific sexual characteristics past the usual age of onset of puberty. The person may have no physical or hormonal signs that puberty has begun. In the United States, girls are considered to have delayed puberty if they lack breast development by age 13 or have not started menstruating by age 15. Boys are considered to have delayed puberty if they lack enlargement of the testicles by age 14. Delayed puberty affects about 2% of adolescents.

Hypogonadism means diminished functional activity of the gonads—the testicles or the ovaries—that may result in diminished production of sex hormones. Low androgen levels are referred to as hypoandrogenism and low estrogen as hypoestrogenism. These are responsible for the observed signs and symptoms in both males and females.

Pubarche refers to the first appearance of pubic hair at puberty. It is one of the physical changes of puberty and can occur independently of complete puberty. The early stage of sexual maturation, also known as adrenarche, is marked by characteristics including the development of pubic hair, axillary hair, adult apocrine body odor, acne, and increased oiliness of hair and skin. The Encyclopedia of Child and Adolescent Health corresponds SMR2 with pubarche, defining it as the development of pubic hair that occurs at a mean age of 11.6 years in females and 12.6 years in males. It further describes that pubarche's physical manifestation is vellus hair over the labia or the base of the penis. See Table 1 for the entirety of the sexual maturity rating description.

Kallmann syndrome (KS) is a genetic disorder that prevents a person from starting or fully completing puberty. Kallmann syndrome is a form of a group of conditions termed hypogonadotropic hypogonadism. To distinguish it from other forms of hypogonadotropic hypogonadism, Kallmann syndrome has the additional symptom of a total lack of sense of smell (anosmia) or a reduced sense of smell. If left untreated, people will have poorly defined secondary sexual characteristics, show signs of hypogonadism, almost invariably are infertile and are at increased risk of developing osteoporosis. A range of other physical symptoms affecting the face, hands and skeletal system can also occur.

<span class="mw-page-title-main">Testicular atrophy</span> Reduction in the size and function of the testicles

Testicular atrophy is a medical condition in which one or both testicles diminish in size and may be accompanied by reduced testicular function. Testicular atrophy is not related to the temporary shrinkage of the surrounding scrotum, which might occur in response to cold temperature.

Late-onset hypogonadism (LOH) or testosterone deficiency syndrome (TDS) is a term for a condition in older men characterized by measurably low testosterone levels and clinical symptoms mostly of a sexual nature, including decreased desire for mating, fewer spontaneous erections, and erectile dysfunction. It is the result of a gradual drop in testosterone; a steady decline in testosterone levels of about 1% per year can happen and is well documented in both men and women.

<span class="mw-page-title-main">Testosterone enanthate</span> Chemical compound

Testosterone enanthate is an androgen and anabolic steroid (AAS) medication which is used mainly in the treatment of low testosterone levels in men. It is also used in hormone therapy for women and transgender men. It is given by injection into muscle or subcutaneously usually once every one to four weeks.

<span class="mw-page-title-main">Testosterone propionate</span> Chemical compound

Testosterone propionate, sold under the brand name Testoviron among others, is an androgen and anabolic steroid (AAS) medication which is used mainly in the treatment of low testosterone levels in men. It has also been used to treat breast cancer in women. It is given by injection into muscle usually once every two to three days.

<span class="mw-page-title-main">Aromatase excess syndrome</span> Medical condition

Aromatase excess syndrome is a rarely diagnosed genetic and endocrine syndrome which is characterized by an overexpression of aromatase, the enzyme responsible for the biosynthesis of the estrogen sex hormones from the androgens, in turn resulting in excessive levels of circulating estrogens and, accordingly, symptoms of hyperestrogenism. It affects both sexes, manifesting itself in males as marked or complete phenotypical feminization and in females as hyperfeminization.

Hypergonadotropic hypogonadism (HH), also known as primary or peripheral/gonadal hypogonadism or primary gonadal failure, is a condition which is characterized by hypogonadism which is due to an impaired response of the gonads to the gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH), and in turn a lack of sex steroid production. As compensation and the lack of negative feedback, gonadotropin levels are elevated. Individuals with HH have an intact and functioning hypothalamus and pituitary glands so they are still able to produce FSH and LH. HH may present as either congenital or acquired, but the majority of cases are of the former nature. HH can be treated with hormone replacement therapy.

<span class="mw-page-title-main">Inborn errors of steroid metabolism</span> Medical condition

An inborn error of steroid metabolism is an inborn error of metabolism due to defects in steroid metabolism.

Hyperestrogenism, hyperestrogenic state, or estrogen excess, is a medical condition characterized by an excessive amount of estrogenic activity in the body.

<span class="mw-page-title-main">Leydig cell hypoplasia</span> Medical condition

Leydig cell hypoplasia (LCH), also known as Leydig cell agenesis, is a rare autosomal recessive genetic and endocrine syndrome affecting an estimated 1 in 1,000,000 individuals with XY chromosomes. It is characterized by an inability of the body to respond to luteinizing hormone (LH), a gonadotropin which is normally responsible for signaling Leydig cells of the testicles to produce testosterone and other androgen sex hormones. The condition manifests itself as pseudohermaphroditism, hypergonadotropic hypogonadism, reduced or absent puberty, and infertility.

Gonadotropin-releasing hormone (GnRH) insensitivity also known as Isolated gonadotropin-releasing hormone (GnRH)deficiency (IGD) is a rare autosomal recessive genetic and endocrine syndrome which is characterized by inactivating mutations of the gonadotropin-releasing hormone receptor (GnRHR) and thus an insensitivity of the receptor to gonadotropin-releasing hormone (GnRH), resulting in a partial or complete loss of the ability of the gonads to synthesize the sex hormones. The condition manifests itself as isolated hypogonadotropic hypogonadism (IHH), presenting with symptoms such as delayed, reduced, or absent puberty, low or complete lack of libido, and infertility, and is the predominant cause of IHH when it does not present alongside anosmia.

Follicle-stimulating hormone (FSH) insensitivity, or ovarian insensitivity to FSH in females, also referable to as ovarian follicle hypoplasia or granulosa cell hypoplasia in females, is a rare autosomal recessive genetic and endocrine syndrome affecting both females and males, with the former presenting with much greater severity of symptomatology. It is characterized by a resistance or complete insensitivity to the effects of follicle-stimulating hormone (FSH), a gonadotropin which is normally responsible for the stimulation of estrogen production by the ovaries in females and maintenance of fertility in both sexes. The condition manifests itself as hypergonadotropic hypogonadism, reduced or absent puberty, amenorrhea, and infertility in females, whereas males present merely with varying degrees of infertility and associated symptoms.

Androgen deficiency is a medical condition characterized by insufficient androgenic activity in the body. Androgen deficiency most commonly affects women, and is also called Female androgen insufficiency syndrome (FAIS), although it can happen in both sexes. Androgenic activity is mediated by androgens, and is dependent on various factors including androgen receptor abundance, sensitivity and function. Androgen deficiency is associated with lack of energy and motivation, depression, lack of desire (libido), and in more severe cases changes in secondary sex characteristics.

Gender-affirming hormone therapy (GAHT), also called hormone replacement therapy (HRT) or transgender hormone therapy, is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals for the purpose of more closely aligning their secondary sexual characteristics with their gender identity. This form of hormone therapy is given as one of two types, based on whether the goal of treatment is masculinization or feminization:

<span class="mw-page-title-main">Testosterone (medication)</span> Medication and naturally occurring steroid hormone

Testosterone (T) is a medication and naturally occurring steroid hormone. It is used to treat male hypogonadism, gender dysphoria, and certain types of breast cancer. It may also be used to increase athletic ability in the form of doping. It is unclear if the use of testosterone for low levels due to aging is beneficial or harmful. Testosterone can be used as a gel or transdermal patch that is applied to the skin topically, intramuscular injection (IM), buccally, or as an oral tablet.

<span class="mw-page-title-main">Androstanolone</span> Androgenic and anabolic steroid medication

Androstanolone, or stanolone, also known as dihydrotestosterone (DHT) and sold under the brand name Andractim among others, is an androgen and anabolic steroid (AAS) medication and hormone which is used mainly in the treatment of low testosterone levels in men. It is also used to treat breast development and small penis in males. Compared to testosterone, androstanolone (DHT) is less likely to aromatize into estrogen, and therefore it shows less pronounced estrogenic side effects, such as gynecomastia and water retention. On the other hand, androstanolone (DHT) show more significant androgenic side effects, such as acne, hair loss and prostate enlargement.

Hypergonadotropic hypergonadism is an endocrine situation and subtype of hypergonadism in which both gonadotropin levels and gonadal function, such as sex hormone production, are abnormally high. It can be associated with hyperandrogenism and hyperestrogenism and with gonadal cysts and tumors. It can be caused by medications such as gonadotropins, gonadotropin-releasing hormone agonists, nonsteroidal antiandrogens, and selective estrogen receptor modulators, as well as conditions like human chorionic gonadotropin-secreting tumors, complete androgen insensitivity syndrome, and estrogen insensitivity syndrome.

References

  1. ↑ Danner HG (2014). A Thesaurus of English Word Roots. Rowman & Littlefield. p. 350. ISBN   978-1-4422-3326-3 . Retrieved 3 May 2021.
  2. ↑ Grossmann, Mathis (2018-05-16). "Hypogonadism and male obesity: Focus on unresolved questions". Clinical Endocrinology. 89 (1): 11–21. doi:10.1111/cen.13723. hdl: 11343/283894 . ISSN   0300-0664.
  3. ↑ Molina PE (2018). Endocrine physiology (Fifth ed.). New York: McGraw-Hill Education. ISBN   978-1-260-01935-3.
  4. ↑ "An Overview of Hypergonadism". CCCHC. 2020. Retrieved 2022-07-25.
  5. ↑ "Hypergonadism". hospitals.aku.edu. Retrieved 2022-07-25.
  6. 1 2 Medvei, V. C. (1982). "A History of Endocrinology". Springer Science & Business Media. doi:10.1007/978-94-009-7304-6.
  7. 1 2 Sissa, Giulia (1992-03-01). "Membres à fantasmes". Terrain (18): 80–86. doi: 10.4000/terrain.3034 . ISSN   0760-5668.
  8. 1 2 Rochira, Vincenzo; Guaraldi, Giovanni (September 2019). "Hypogonadism in the HIV-Infected Man". Endocrinology and Metabolism Clinics of North America. 43 (3): 709–730. doi:10.1016/j.ecl.2014.06.005. ISSN   0889-8529.
  9. 1 2 Nieschlag, Eberhard; Behre, Hermann M.; Nieschlag, Susan (eds.), "Plate Section", Testosterone, Cambridge: Cambridge University Press, retrieved 2024-10-02


This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.